This study investigated the safety and effectiveness of coiling with stents compared to ordinary coiling for the treatment of brain aneurysms. 

A brain aneurysm occurs when the walls of blood vessels in the brain weaken, causing the blood vessel to bulge with blood, which increases the risk of rupture. Blood vessels can become weak due to high blood pressure or trauma. When an aneurysm ruptures, blood is leaked into the surrounding area (hemorrhagic stroke) causing damage and can be life threatening.

A way to prevent a brain aneurysm from rupturing is an operation called coiling where a soft, flexible coil is inserted into the aneurysm space via a catheter (flexible tube). The coil inside the aneurysm causes the blood to clot and seals off the aneurysm so blood from the artery can’t enter and thus prevents it from rupturing. However, aneurysms reoccur in about 30% of coiling procedures. Therefore, coiling with expandable stents was introduced to keep the coil in place inside the aneurysm. Stent-assisted coiling involves permanently placing a mesh tube in the blood vessel beside the aneurysm to provide a scaffolding of support to keep the coil within the aneurysm sac. 

This study reviewed data online that compared the safety and efficiency of stent-assisted coiling and coiling-alone for the treatment of brain aneurysm. Positive outcomes such as aneurysm occlusion (sealed off aneurysm) and progressive thrombosis (blood clotting in aneurysm sac) as well as negative outcomes such as complications and mortality (death) were recorded. The studies showed that although stent-assisted coiling tended to show an initial lower occlusion rate compared to coiling-only, stent-assisted coiling achieved a significantly higher progressive thrombosis rate during the follow-up (38%) compared to coiling-only (19%), and showed significantly lowered aneurysm recurrence rate (16%) compared to coiling-only (18%). The occurrence of complications or mortality did not show significant differences between the two coiling groups. 

This study shows that stent-assisted coiling is more effective than coiling-only, yet is just as safe. 

The studies included in this review had different follow-up periods, so the incidence of long-term complications or mortality may not have been reported in shorter trials. 

If you, or someone you know, is due to receive treatment for a brain aneurysm, talk to a doctor about which coiling method is most effective and safe.